Whenever I hear people say this, it makes me go crazy because it shows an utter lack of understanding of grapefruit oil chemistry. Grapefruit juice is not the same thing as grapefruit oil.

Grapefruit JUICE contains many compounds that are very potent inhibitors or drug metabolizing enzymes known as cytochromes or CYPs. When you inhibit your CYPs, you are risking your drug levels going higher.

You start with your drug.

You have a compound that inhibits the enzymes that breakdown of those drugs.

Your drug levels go higher.

Medications that can be effected by grapefruit JUICE include cholesterol-lowering medicine such as statin drugs, certain anti-anxiety, anti-allergy, anti-arrhythmic medicines, and even some antibiotics and anti-hypertensives.

Here is the difference between grapefruit oil and grapefruit juice…

Grapefruit juice contains very high levels of a compound calls 6,7-DHB. DHB is a flavonoid that very strongly inhibits drug metabolizing enzymes. Whereas grapefruit OIL does not contain high levels of 6,7-DHB. It DOES contain levels of bergotamins and bergeptins. These too can inhibit cytochromes, but not nearly to the extent as DHB.

So DHB is found in high levels of the juice but not in the oils. So the likelihood of having clinically important drug interactions with grapefruit oil much, much lower than the risk of having clinically important drug interactions with grapefruit juice.

Now I would not be a good pharmacist if I didn’t tell you that it’s important for you, if you’re on medications, to know the side effects of those medications and to know the risks and benefits of those medications. If you’re on a medication that interacts with grapefruit juice, as well as on a statin drug, please be advised to look out for things like muscle cramps, or darkening of the urine because this could be an example of a drug interaction. Always talk to your doctor and your pharmacist about the side effects of your medication so if you have problems then you know how to protect yourself.

Is grapefruit oil and inhibitor of drug metabolizing enzymes? Not to the same extent as grapefruit juice.

The data covering lavender oil and gynecomastia—breast swelling—in young boys is so hotly contested…there are so many articles that were published after the article that “demonstrated” that lavender oil causes breast swelling in young boys. There was a publication in the New England Journal of Medicine…and it led to a response in the New England Journal of Medicine entitled “Lack of Evidence that Essential Oils Effect Puberty” and this was published in the Journal of Reproductive Toxicology.

In the original publication, there were three case reports that were said to link lavender and tea tree oil to breast swelling in young boys. The problem was that the authors did not note a full list of ingredients in the products that they cited nor did they account for any of the xenoestrogenic contaminants including plasticizers, pesticides, and herbicides.

Other problems…they did their own experiments where they tried to demonstrate that lavender caused breast swelling and cause estrogenic effect.

They bought their essential oil from a chemical company, not from an essential oil company. So they could have gotten synthetic essential oil, they could have gotten something that was low quality, they could have gotten anything…because they bought it from a chemical company.

To determine whether the lavender oil was estrogenic (mimicking estrogen) or androgenic (mimicking testosterone) the used a a cell culture. And in the cell culture they used DMSO which is known to already effect estrogen levels. When they made their cell cultures, they did it in polystyrene (plastic) plates. Both DMSO and polystyrene are known to modulate estrogens and androgens.

They also selected to do a cell culture instead of a uterotrophic assay. Uterotrophic assays are the test to determine whether uterine lining grows in response to a chemical. This is the most widely criticized point of this study because uterotrophic assays are the gold standard for testing if a compound has estrogenic or androgenic qualities.

At the conclusion of the article, the authors themselves admit that their article was inconclusive to determine causality. Causality is when you have good enough data to say, “THIS makes THIS happen.” Causality is something. We know that water hydrates things. The authors themselves said, “We don’t know, based on this data, if this is correct.”

In my professional opinion, lavender oil and breast swelling in young boys can be a consideration if you want to be super-duper conservative, but it would never preclude me. personally, from recommending lavender oil for a young boy.

Terrible article. Really hotly contested. This is one reason I won’t buy into fear mongering online about essential oils. Let’s not let one terrible article sway us from product that we know are good for our bodies.

There is no definitive list of essential oils that should be avoided in people on blood thinners. However there are some oils that have the risk of potentiating. (Potentiation, in medical terms, is like it makes the drug effect more.) For example, wintergreen essential oil. There is a rish that the methyl salicylate in wintergreen oil can interact with different blood thinners.

Here’s the thing… in many of the studies that concluded that wintergreen could interact with blood thinners, there were two problems…

Wintergreen essential oil is one of the easiest oil to manipulate and synthesize. So, in articles regarding wintergreen, it’s very difficult to draw any conclusions if the oil was not designated as synthetic or natural. Look very closely in the articles…are they talking about “wintergreen essential oil”? Or are they talking about “oil of wintergreen”? These are two entirely different different products. “Oil of wintergreen” indicates that it is a 100% synthetic that is used.

The other thing about articles on wintergreen essential oil is that many of them don’t look at the whole oil, they look simply at isolated methyl salicylate. Some scientists may argue, “Well, yeah, but wintergreen oil is 95-99% methyl salicylate.” Okay, still…that 1-5% could potentially be important.

How do salicylates interact with our bodies and potentially cause blood thinning? They increase the risk of blood thinning in a couple of ways…

They directly effect platelet function which can increase the risk of bleeding in people on blood thinners.

High levels of salicylates can influence your INR (a way we measure how thing the blood is while on blood thinners). They can prolong INR by decreasing levels of vitamin K dependent coagulation factors (things that make the blood stick together, which is sometimes what you want o happen).

Salicylates kick warfarin off of a protein. In the blood, we have plasma-binding proteins that kind of move around different molecules. Warfarin, or coumadin, will stick to those and move around throughout the blood. Salicylates come in and kick those off, which means you have more free drug floating around the body, which means you have more drug action.

Here’s another thing… many of the studies where people have demonstrated that wintergreen essential oil a) dangerous, b) increases the risk of bleeding… people took 15 ml, 5 ml, 45 ml of essential oil.

Everybody… I want you to promise me that you will never drink 45 ml of any essential oil ever in my life. I understand that drinking that much essential oil is bad for my health.

Let’s not overuse essential oils. We know how potent they are.

So when I read these studies where it’s like, “Oh, a 17-month-old died…” The 17-month-old died after her mom gave her an entire teaspoons—15 ml—of essential oil. Please don’t do that!

If you choose to use essential oils while on blood thinners… Again, I want to be a good pharmacist… I want to teach you how to be the safest you can possibly be if you’re on medications while you use essential oils. If you’re using wintergreen or another essential oil—perhaps clove or some other ones—know the signs and symptoms of bleeding:

nosebleeds

bloody gums after brushing or flossing

bruises that don’t heal in a way that is normal for you

vomiting of blood or anything that look like coffee grounds

pooping blood or anything that looks dark and tarry

If any of those things happen to you while you are on a blood-thinning medicine, it is important for you to contact your doctor or pharmacist or whoever manages your anitcoagulation, and let them know that you are wondering if you might be having a side effect.

Wintergreen is very commonly used as a food flavoring agent throughout all of the world and is used in things like chewing gums, candies, etc.

I had someone ask again about sulfa medicines and Sulfurzyme. Go back and watch my on Sulfurzyme where I go through a detailed explanation of why people who are allergic to sulfa medications can take Sulfurzyme. Sulfa and sulfur are not at all the same thing.